Rebuttal to Feinstein's Response to my LTE in Psychotherapy Networker

Today I saw the print version of my Letter to the Editor published in the March/April issue of the Psychotherapy Networker in response to Feinstein's case study on energy psychology.  I was very disappointed that they cut the most important parts of my letter, so I'm very glad that I was able to reproduce the entire uncut version here on my blog. As is customary and expected, Feinstein got to have the last word as the author of the piece. Nevertheless, this is my blog and I shall have my say here in rebuttal to his response because there are a number of points that really need a response!  So here it is, a point by point rebuttal to his response.

Feinstein wrote:

"Nothing in the article downplayed the usefulness of clinical research, to which I'm strongly committed. Rather, the article addressed the dilemma of how to assess a new therapy during the period between its introduction and the accumulatioin of research that confirms or disconfirms its efficacy -- the core issue in the controversy about evidence-based therapies."

Monica's response: Feinstein completely missed the core point of my letter (which unfortunately was cut by the Editor). The issue here is that Energy Psychology and TFT are not new. They have been around for 25 years and that is plenty of time to accumulate good research.  Yet no such research exists.  How long a period does Feinstein think a therapy needs before it begins publishing controlled studies in reputable journals?  More than 25 years?

Feinstein: "While I presented cases that were intentionally selected for their demonstration value (and this was acknowledged within the article), ..."

Monica: Feinstein did not acknowledge the problems with reporting results from public demonstrations and the many other factors other than the treatments that could explain their apparent success.  Public demos can create social demand characteristics. Both Feinstein and Callahan do not seem to grasp this.

Feinstein continues: "energy psychology isn't without empirical support (see www.energypsychologyresearch.com ). "

Monica: I checked out that website and with only a few exceptions, the exact same claims being made there about anecdotal reports, case studies and "systematic" observation could readily be made by Scientologists (the only difference being that they have over 50 years of such experiences). The problem is that the plural of anecdote is not data.

The problem is that the studies adduced in support of EP (with only one exception, a study on phobia of small animals with EFT by Steve Wells, et al with only very limited conclusions) are not controlled studies published in reputable peer reviewed journals.

Feinstein: "In addition, the Waite and Holder study has been soundly criticized for drawing conclusions that aren't consistent with the study's own data."

Monica: "Soundly criticized" by whom?  References, please. Yours is the first written criticism I've seen.

Feinstein:  "Specifically, all three tapping treatments reduced fears while a control condition didn't.  Yet the authors concluded that the effectiveness of the method investigated 'appears unrelated to [its] unique features."

Monica: Yes, and again Feinstein appears to be missing the point. There was no significant difference between tapping on a doll, using sham points, and using meridian points.  The unique feature is the meridian system, yet people responded when a doll was tapped.  A doll has no meridian system.

Feinstein: "And although they question whether tapping was the active ingredient, the authors do acknowledge 'the present study establishes that certain techniques used by EFT may be useful in the treatment of fear."

Monica: That sentence is taken way out of context!  The statement that followed was: "However, this effectiveness appears unrelated to the unique features of EFT and instead derives from components shared with more traditional therapies already established as effective treatments for specific phobia."

Feinstein: "Ms. Pignotti is also a bit misleading when she states that 'no one was cured of their phobia' since the 'treatments' lasted only two to three minutes and the subjects weren't diagnosed with phobias."

Monica: Actually, most of the participants got the collarbone breathing after the initial sequence and then a second round of treatment.  Nevertheless, even if there was only one round, the claim these techniques make is to be able to cure phobias, sometimes in minutes so I should think that out of a sample of more than 100, at least a few people should have been quickly cured of phobias or fears. Yet Waite & Holder report that a large number of participants had less than a 2 point drop in their SUD after the initial round. 

As for his comment that the participants were not diagnosed with phobias, that's an interesting double standard because in most of the studies adduced in support of TFT and EP, no formal diagnosis was made either. The bottom line is that the participants reported a specific fear with a SUD level and that the change in SUD was not robust, as has been reported so often anecdotally and in uncontrolled studies done by proponents.

So I'll reiterate what the bottom line is. EP has been around for 25 years, so for Feinstein to characterize it as a "new" therapy is highly misleading.  It's time to show us the data, and I mean properly designed controlled studies published in reputable peer refereed journals (not the self-published ones run by believers).